FTB 3500 Exemption Application PART FOUR -- CHURCH

If claiming exemption as a church, attach a statement including the information requested in item (1) through item (8) below:

NONPROFIT CHURCH Name

*Email

Does the organization have a regular congregation or conduct religious services on a regular basis?

How many usually attend the regular worship services? Fax us, mail us or email us samples of worship service programs and newspaper announcements of your activities. Where and how often are religious services held?. . . . . . .

What amount of the annual gross income will be received from incorporators, ministers, officers, directors, or their families?

What amount of the organizationís proposed expenditures will be used for the personal living expenses of the incorporators, ministers, officers, directors, or their families?

6) How many hours per week will the religious or spiritual leader (s) devote to organizational activities? Will this person (s) engage in employment unrelated to the activities of the organization? If so, indicate the number of hours per week and describe the employment activity

List all the officers, directors, trustees, etc., of the organization .

and describe their qualifications for such office

Director 1

Director 2

Director 3

Director 4

Director 5

Officer 1

Officer 2

Officer 3

Officer 4

Are any of the officers or directors related by blood or marriage? If "Yes," explain.

(8) Will any founder, member, or officer:

(a) Take a vow of poverty?

(b) Transfer personal assets to this organization, like a home, automobile, furnishings, business, or recreational assets, etc., that will be made available for the personal use of the donor (s)?

(c) Assign or donate to the organization income that will be used in part or whole to pay the donor(s) as salary, stipend, or living allowance (such as food, medical expenses, clothing, insurance, etc.)?